Evidence map›Paper›PMID 42403710›Full record

ArticleFrontiers in pharmacology2026

A decade of clinical trials in Italy (2016-2025): trends, regulatory transformation and biotechnological evolution.

Eleonora De Paola, Diego Alejandro Dri, Natalia Maria Verrelli, Fabrizio Galliccia

Abstract read
In one paragraph

Article in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Eleonora De PaolaClinical Trials Office, Italian Medicines Agency (AIFA), Rome, Italy.
Diego Alejandro DriClinical Trials Office, Italian Medicines Agency (AIFA), Rome, Italy.
Natalia Maria VerrelliClinical Trials Office, Italian Medicines Agency (AIFA), Rome, Italy.
Fabrizio GallicciaClinical Trials Office, Italian Medicines Agency (AIFA), Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Italy represents one of major hubs for clinical research in Europe, nevertheless comprehensive long-term analyses of its clinical trial landscape under evolving regulatory frameworks remain limited. This study examines the trends of clinical trials submitted to the Italian Medicines Agency (AIFA) over a 10-year period, evaluating the impact of the COVID-19 pandemic, the transition to Regulation (EU) No. 536/2014 (CTR) and the introduction of the EU Clinical Trials Information System (CTIS). Methods: All clinical trial applications submitted to AIFA between January 2016 and December 2025 were analysed, integrating data from the Osservatorio sulla Sperimentazione Clinica dei medicinali (OsSC), the European Union Drug Regulating Authorities Clinical Trials Database (EudraCT), and the CTIS. Trials were categorised by year, therapeutic area and Investigational Medicinal Product (IMP) characteristics, and were further analysed by phase, sponsor profile, and study population. Results: A total of 7,449 clinical trials were submitted over 10 years, showing overall stability with marked fluctuations: a pandemic-driven peak in 2021 (n = 864), a regulatory transition through 2023 (n = 688) and a recovery in 2025 (n = 838). Oncology dominated the therapeutic area distribution, followed by neurological diseases, though both declined; immune-related diseases increased steadily, alongside cardiovascular and respiratory areas. Biological IMPs increased, chemical compounds declined and antibody-drug conjugates tripled by 2025, signaling a biotechnological shift. Phase II and III trials predominated, confirming Italy's role in confirmatory research. Phase I showed the most consistent growth, especially post-pandemic, while Phase IV decreased. Commercial sponsors dominated and recovered faster post-COVID-19, while non-commercial research declined. The elderly (≥65 years) and paediatric populations remained systematically underrepresented. Conclusion: The Italian clinical trials setting appears resilient with a tendency toward increased activity, a strong oncology focus, and developments in other areas. It remains highly attractive for industry-sponsored trials yet structurally imbalanced. Persistent weaknesses include limited support for non-commercial research, systematic underrepresentation of key populations and, a decline in independent post-marketing studies. Targeted policy interventions are needed to strengthen academic research capacity and better align clinical research with national and European public health priorities.

Indexed as

AIFAbiotech actclinical trialsCOVID-19CTISEudraCTOsSCregulation (EU) 536/2014

Identifiers

PMID42403710
PMCPMC13327920

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.